Choice in Public Health Services: A Multilevel Analysis of Perceived Primary Care Doctor Choice in 22 Countries
Administration and Society, 2015 Forthcoming
29 Pages Posted: 18 Dec 2014
Date Written: December 17, 2014
The introduction of choice in public services, and in health services more specifically, is part of a wider movement to introduce consumerism in health care. In this article, we analyze how citizens perceive the availability of choice of primary care doctors in 22 European countries, and what drives these opinions using multilevel analyses on data from the European Social Survey (Round 2, 2004; 22 countries, N=33,375). We distinguish between individual factors and structural or country-level factors. We find that neither whether there actually is free choice of primary care doctors in a country, nor the density of doctors or health expenditure has an impact on perceptions of having enough choice. Perceptions are furthermore influenced by one’s personal health situation, age, sex, whether one lives in a rural area, and satisfaction with the health system.
Keywords: choice, primary care doctors, general practitioner, patient empowerment, consumerism, health reform
JEL Classification: D71, D73, I11, I18
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